The prevalence and severity of mental health and chemical dependency disorders on college campuses have reached crisis levels. A national survey of 29,230 college students in 2002 found that, at some point during the previous year, 45 percent had felt so depressed that they could not function;65 percent had felt "things were hopeless." Chemical dependency is widespread and has become normative on many campuses. Half of all students report that they "drink to get drunk." Similar findings were reported following a survey of 80,000 college students in 2007-2008. Mental health and chemical dependency claim over 2,000 student lives each year. COMS will provide automated outcomes management for college health services. It will help college counseling centers (CCCs) and college health centers (CHCs) respond more effectively to the crisis. As the first outcomes management system (OMS) appropriate for use on college campuses, COMS will provide student health programs with the same evidence-based treatment screening, planning, and progress monitoring capabilities introduced successfully in behavioral health settings across the nation. It will provide: (1) Behavioral healthcare screening and clinical decision support: COMS will help to identify students suffering from serious behavioral health (mental health, substance abuse) disorders, or at risk for life threatening conditions such as eating disorders (ED), self-harm (e.g., cutting) and suicidality;(2) Effective screening for chemical dependency (CD), linked to appropriate interventions. COMS will enable CCCs to fully integrate screening with Motivational Enhancement Interviewing (MEI), promoting readiness to change among a population that considers heavy drinking and drug use to be normative;(3) Multivariate severity ("case mix") adjustment, allowing for valid comparisons of treatment outcomes across programs and meaningful quality improvement initiatives;(4) Continual enhancement of its ability to evaluate "what works for whom," as its database of patient characteristics, treatments and outcomes expands;(5) Population screening (anonymous): COMS will be made available on the CCC website to support its outreach function. Students who complete the COMS assessment will receive self-help materials, tailored lists of college, local (e.g., AA/NA groups) and national (hotlines, links to NIDA, NIAAA and NIMH web sites) resources, and the offer of a dynamic referral to the CCC, CHC or local providers;(6) Assessment of risk for dropout;and (7) Utility for research. Phase II specific aims include: (1) Develop data quality indicators;(2) Automate the monitoring assessment and report;(3) Provide remote and anonymous web access;(4) Develop and field test COMS for CHCs;(5) Derive predictive algorithms for treatment response and college dropout;(6) Integrate COMS into an electronic practice management system;and (7) Provide dynamic referral, self-help and lists of tailored resources. PUBLIC HEALTH RELEVANCE: The prevalence and severity of mental health and chemical dependency disorders on college campuses have reached unprecedented levels. Mental health and chemical dependency claim over 2,000 student lives each year. COMS will provide student counseling centers and health programs with automated assessment for behavioral healthcare, in support of evidence-based treatment screening, planning, and progress monitoring.